Abcess/Bacteria in jaw / Dental Implants

[flz2006]

Hello everyone, be nice, this is my first post!

I have always had bad teeth - umpteen fillings (even in milk teeth), crowns, root canals and then last year I cracked an upper canine and had to have it removed. I've had a bridge fitted to replace this which I am not happy with, but am putting up with. Then about 6 months ago I had an abcess under a rear molar tooth. I perservered with antibiotics for about a month but then the dentist insisted I have the tooth out much to my dismay.

This was my main "chewing" tooth and chewing on the other side of my mouth has made my bridge wobbly (it's been re-cemented twice already now and is wobbly again today). So I have decided to have an implant to replace the missing molar as I really don't want another bridge. I have been referred to a specialist who following my consultation today (had all the x-rays done previously) has informed me that I have bacteria/infection (he wasn't specific) in 3 areas in my jaw. He has suggested 3 phases of treatment:-

(1) remove another tooth next door but one to my missing molar (root treated), clean out the bacteria and then insert 2 implants + crowns.

(2) lower jaw, middle front teeth - more bacteria/infection under teeth - remove two (perfectly good) central incisors, clean out infection, insert implant, 2 crowns placed on one implant.

(3) upper jaw - remove current bridge (3 teeth), remove two front (root treated) crowns, remove bacteria/infection, do bone graft, and then insert 2 x implants. Put 4 crowns onto these implants and then crown the 5th pre-molar tooth individually as it's sound enough.

I can't really afford to do all this treatment, and to be fair he's not pushing me to, but I am rather worried by the infection he spoke of. It's true I have always had abcesses whenever I've had crowns done in the past, and I knew that one of the teeth had an infection at the root of it which my own dentist said to ignore as it wasn't doing any harm. I also understand the need to ensure that any infection is cleared up before doing implants as it's a big deal and you really want a clean environment. I don't think the specialist is lying to me or anything - I can see what he's talking about on the x-rays myself - but why have my previous dentist(s) said it was ok to leave this infection alone, and now I'm told the infection is eating into the bone and, for the upper jaw at least, I'll need bone grafts?

The plan is to get stage (1) done first of all. I can then see how well the implant works as opposed to previous crowns/the bridge. Assuming it goes well then maybe I can find the money to replace the bridge. It's just sods law that this first implant leads to yet another extraction and I can't help worrying that I am losing all my teeth (I'm 38 years old). What happens if the implant doesn't take (I know there's a 95% success rate, but with all this bacterial infection in my jaw it's hardly best case scenario) and then I've lost another tooth. I had to wear a plate when the first tooth was extracted before the bridge was fitted and I really don't think I could cope with dentures. I guess I'm feeling that it's better the devil you know at present!

Oh it's just such a hard decision! Where is the crystal ball when you need it?!

Well I am definitely going to see another implant dentist/specialist for a second opinion as it's a really big step to take (the specialist today suggested it). I realise I'm kind of in shock from the appointment today and I guess I'm just trying to understand it all. So if anyone has any thoughts or advice or can explain this "it's not a problem/it is a problem" bacterial infection then please do leave me a message.

and thanks for listening!

 

[DrMike]

the implant dentist will offer different advice as s/he has more experience in that type of area than the general dentist. i am a general dentsit however i work with a couple of implantologists and have picked up quite alot from them.
quite often implantologists talk about removing certain teeth for patients for specific reasons which i may have been tempted to try to hold onto however when the reasons are explained to me make perfect sense. I will try to pass on some of what I have picked up from the implantologists here;
if there is a chronic infection- ie grumbling away, not causing immediate pain/problems- the infection slowy deteriorates the bone. obviously if they are placing an implant in a gap next to a tooth with a chronic infection, there is then the risk of you not only losing the tooth with the infection- but also the implant! so, often they recommend removal of that tooth as well and implant placement as then there is the best chance of long term success.
also if teeth with chronic infections are left (eg i assume the lower front teeth you mentioned)- the bone quality gets worse and worse, and if left until the otherwise seemingly good tooth suddenly abscesses or has other problems- it may be that the tooth is to be extracted and an implant is no longer an option, or much more complex grafting procedures are required.
The theory of the treatment plan does sound ok to me- however- I am not an implantologist - I would get a 2nd opinion to set your mind at ease. Also do ask them to explain exactly why they would do what they suggest- they should be able to explain to you all the hows and whys- you will spent ALOT of money- you deserve to know why!!
Implants are expensive- but excellent. the failure rate is very low, and often the implantologist will plan the placement in such a way that even in the rare event off one actually failing- there would be a plan B!
all the best with your treatment- i hope this helps a bit!
Kind Regards
Mike

 

[flz2006]

Thank you both for responding to my post. I am definitely going to get a second opinion, it's too important an issue not to really.

I did say before that I do believe the dentist when he tells me this treatment is in my best interests, and I don't think he is overcharging me or trying to swindle me or anything! But I just can't get my head round the fact that for the last 20 years I've been told to leave these infections alone and they will do no harm and now suddenly I'm told the infection is eating into my bone and could cause problems.

I'm pleased to say that after sleeping on it I do feel better about things . I guess my mum was right about that one at least! So I shall sort out a second opinion and take stock of the situation from there.

I thought I had problems with my fillings and crowns before, little did I know I was in the little league then!

Thanks again for responding, and for everyone's support on this site. It's really nice to see people replying and taking an interest just to keep everyone's spirits up and not only to offer practical advice.

Keep up the good work.